Ankle sprains are one of the most common musculoskeletal injuries.
Post the initial reduction of symptoms of pain and swelling , the rehabiliation is never initiated for 60–75% of the people with ankle sprain .According to recent research it was found that , only 28% patients are prescribed therapeutic exercises after ankle sprain.
HERE ARE FEW OF THE REASONS WHY ANKLE SPRAINS NEED NOT BE TAKEN LIGHTLY ,post the initial settlement of the inflammatory symptoms. :
- In the acute phase, ankle sprains Cause pain and loss of function.
2. loss of work -1/4 th of the injured people are unable to attend school or work for more than seven days causing long term risks of reinjury or residual problems.
3. Only 36% to 85% patients have had full recovery in three years post an ankle sprain due to incomplete treatment.
4. Ankle sprains are often regarded as minor injuries but they cause short term immobility and loss of function, with a risk of long term problems and reinjury.
5. Individuals with a history of ankle sprain have approximately 3.5 times greater risk of sustaining another sprain than those who had no history of ankle sprain.
6. lateral ankle sprains contributed to 13% to 22% of all osteoarthritis cases involving the ankle and 80% of posttraumatic osteoarthritis cases.
7. ANKLE SPRAIN leads to Joint injury resulting in proprioceptive deficits hindering functional recovery, and risk longer term ankle instability.
8. untreated ankle sprain causes future subsequent injury to knee, lumbar spine and hip in the long run.
9. Research shows that ankle trauma results in alterations to joint positional sense, balance,muscle activation,kinematics, and neuromuscular patterns causing increased risk of falls .
10. After a traumatic sprain injury, ankle function can be hindered by pain and swelling which causes a reflex inhibition of the surrounding ankle musculature, known as arthrogenic muscle inhibition.
The main aim of initiating the exercise intervention during the acute phases of injury is to initiate early (re)activation of ankle musculature and functional movement patterns.
11. Ankle sprains cause Chronic ankle instability (CAI) . This condition is characterized by a history of one signifcant ankle sprain, subsequent recurrent sprains, episodes of the ankle giving way, or self-reported defcits in ankle function .
12 . CAI causes ankle joint ligament laxity, arthrokinematic restrictions and/or functional insufciencies like neuromuscular inhibition, altered refexes, or decreased balance and joint position sense.
13. A pattern of decreased dorsifexion ROM and restricted posterior talar glide causing ankle stiffness , is also observed in patients with CAI.
14 .The average time to return to sport after lateral ankle sprain is 16 to 24 days but due to incomplete rehabilitation , a large proportion of athletes experience re-injury or other long-term problems .
Epidemiology data of recurrent ankle sprains in athletes range from 12% to 47%, with the largest re-injury rates occurring in junior basketball (47%), volleyball (46%) and American Football (43%) .
70% of the overall population experience at least one ankle sprain in their lifetime.
15. It is estimated that up to 40% of people develop CAI after ankle sprain , leading to post traumatic osteoarthritis .
16. Ankle sprains incur a substantial economic loss,because of the substantial indirect costs due to decreased physical activity, diminished productivity and lower quality of life .
hence ,it is important that patients seek rehabilitation even after minor ankle sprains.
How to avoid the post traumatic complications of ankle sprain???
it is as simple as following a complete rehabilitation program of ankle sprain 0–12 weeks starting from the day of injury till return to function . where in in the last phase, the patient has regained pain-free gait and activities .
The purpose of rehabilitation exercise is to improve muscle strength, range of movement, and sensorimotor control, which are commonly impaired after ankle sprain.
Functional stress of exercises stimulates development of stronger replacement collagen in the injured ligament , hence facilitating faster recovery and healing.
Functional rehabilitation has 4 aspects:
- ROM,
- strengthening,
- proprioception, and
- activity-specific training.
Strengthening of weakened muscles is essential to rapid recovery and is a preventive measure against reinjury.
Exercises should focus on the conditioning of the peroneal muscles because insufficient strength in this group has been associated with CAI and recurrent injury.
Two randomised controlled studies of ankle rehabilitation together with functional treatment for acute ankle sprain found evidence that balance board training and a strength and balance training programme initiated in the first week after sprain, decreased pain and reinjury compared with control groups given only advice on ice, compression, and elevation and no exercise.
hence in summary a complete tailor made rehabilitation program is needed after ankle sprain to prevent loss of quality of life and function in daily activities.
